NPI | 1669096087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1057742) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 213069) |
Enumeration Date | 2020-06-01 |
Last Update Date | 2024-07-23 |